NCC220323_FRO Submitted_20220118

No person may iate any land -disturbing activity on one or more acres as covered by the Act before this
form and an acceptable erosion and sedimentation control plan have been completed and approved by the
Land Quality Section, N,C. Department of Environment and Natural Resources, (Please type or print and, if
the question is not applicable or the e-mail and/or fax information unavailable, place N/A in the blank.)
Part A.
1 - Project Name Matthews Landing Phase I
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Location of land -disturbing activity: County Harnett _City or Township Town of Fu_quay
Highway/Street Harnett Central Road —Latitude N35.475786 Longitude W -78.811320
Approximate date land -disturbing activity will commence: December 2021
Purpose of development (residential, commercial, industrial, institutional, etc-): Residential
Total acreage disturbed or uncovered (including off -site borrow and waste areas): 46
Amount of fee enclosed: $2.990 . The application fee of $65,00 per acre (rounded up to the
next acre) is assessed without a ceiling amount, (Example: a 9-acre application fee is $585)
Has an erosion and sediment control plan been filed? Yes Y No Enclosed
Personto contact should erosion and sediment control issues arise during land -disturbing activity:
Telephone Cell # 989-255-4526 Fax #
Landowner(s) of Record (attach accompanied page to list additional owners)
Mafthgws Land in4Lqtyg!q2MgpL_LLQ__ 989-255-4526
Name Telephone
4925 Greenville Ave., Ste 1400
Current Mailing Address Current Street Address
Dallas Texas 75206
City State Zip City
State Zip
10, Deed Book No.-4074 - Page No. 0356 — Provide a copy of the most current deed
Part B.
1 Person(s) or firm(s) who are financially responsible for the land -disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet):
-Matthew Landing Development LLC
Name
4925 Greenville ave suite 1400
Current Mailing Address
Dallas TX 75206
City State— Zip
[e-mail]
E-mail Address
4925 Greenville ave, suite 1400
Current Street Address
Dallas Tx 75206
City State Zip
Telephone-214 373 7793 Fax Number

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Wake County
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